DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MANDYA D.C.Office Compound, Opp. District Court Premises, Mandya - 571 401. consumer case(CC) No. CC/10/42
Sri. Basavaraju
...........Appellant(s)
Vs.
United India Insurance Co., Ltd.,
...........Respondent(s)
BEFORE:
1. Smt.A.P.Mahadevamma2. Sri.M.N.Manohara
Complainant(s)/Appellant(s):
OppositeParty/Respondent(s):
OppositeParty/Respondent(s):
OppositeParty/Respondent(s):
ORDER
BEFORE THE MANDYA DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MANDYA PRESENT: 1. A.T.MUNNOLI, B.A., LLB., President, 2. M.N.MANOHARA, B.A., LLB., Member, 3. A.P.MAHADEVAMMA, B.Sc., LLB., Member, ORDER Complaint No.MDF/C.C.No.42/2010 Order dated this the 24th day of August 2010 COMPLAINANT/S Sri.Basavaraju S/o Late Siddaiah, R/at Karasavadi Village, Santhe Kasalagere Post, Kothathi Hobli, Mandya Taluk. (Sri.P.R.Raghavendra., Advocate) -Vs- OPPOSITE PARTY/S The Branch Manager, United India Insurance Co., Ltd., M.C.Road, Mandya City. (Sri.K.V.Sheshadri., Advocate) Date of complaint 08.04.2010 Date of service of notice to OP 19.04.2010 Date of order 24.08.2010 Total Period 4 Months 5 days Result The Complaint is dismissed. There is no order as to costs. Sri.A.T.Munnoli, President 1. The Complainant has filed this complaint under Section 12 of the Consumer Protection Act, 1986, alleging deficiency in insurance service on the part of the Opposite party that he being the nominee under the Janatha Personal Accident Policy of the Opposite party of his father who died due to snake bite during the validity period of the policy, but the Opposite party has illegally repudiated the claim. 2. The Opposite party in the version has denied the deficiency alleged and it is contended that the Complainant has not furnished the documents namely FIR, Panchanama, Post Mortem Report, as directed. 3. In support of the claim, the Complainant and a witness are examined and certain documents are marked. On the other hand, a witness for the Opposite party has been examined. 4. We have heard the arguments of both the learned counsel. They have also filed written arguments. We have perused the entire records. 5. Now the point for our consideration is:- Whether the Complainant has proved deficiency in service on the part of the Opposite party and that he is entitled to the relief sought? 6. Our finding on the point is negative, for the following. REASONS 7. There is no dispute that the father of the Complainant by name Siddaiah had taken Janatha Personal Accident Policy of the Opposite party by paying premium of Rs.240/- which was valid from 21.01.2009 to 21.01.2014. The Complainant claims that his father died on 27.08.2009 due to snake bite. He being the nominee along with relevant documents, submitted claim petition to the Opposite party. Opposite party has repudiated the claim on the ground that certain documents are not produced. 8. Considering the evidence on record, though certain facts are admitted, material point to be decided is, whether repudiation of the claim of the Complainant by the Opposite party on the ground of non-submission of the documents such as First Information Report, Panchanama and Post Mortem Report, is legal or otherwise. 9. It is not in dispute that along with he claim petition, the Complainant did not furnish the documents such as FIR, Mahazar and Post Mortem Report. The Opposite party contended that since the Complainant did not furnish the said documents, it called upon the Complainant to furnish said documents. But, the Complainant has not produced those documents. From the material on record, at the cost of repetition, it is fact that said documents are not produced by the Complainant before the Opposite party. 10. The learned advocate for the Complainant submitted that FIR or Post Mortem Report are not mandatory and in support of his submission, he relied upon the ruling reported in I(2000) CPJ 548. It is true, Honble Andhra Pradesh State Commission with reference to the facts and evidence of that case has held that production of FIR or Post Mortem Report is not mandatory. The Honble State Commission narrated the entire facts and in 6th paragraph of the judgement, it is stated that we do not find mention of any FIR, Post Mortem Report or Medical report as mandatory. In the earlier paragraph, the terms and conditions of the policy of that case are referred to. Before us, copy of the policy is placed on record. In the conditions, there is specific mention that in the event of death to make post mortem examination of the body of the insured and such evidence as the company may from time to time require shall have to be furnished within the space of 14 days after demand etc. Hence, in the case on hand, it is one of the terms and conditions of the policy that production of post mortem copy is mandatory. Since, there is specific condition in the policy in question, the ruling relied upon by the learned advocate will not help the Complainant. 11. Further, it is relevant to note that it is one of the conditions of the policy that upon the happening of any event, which may give raise to a claim under this policy, the insured shall forthwith give notice to the company, unless a reasonable cause is shown, the insured should within one calendar month after the event which give raise to a claim etc. In the case on hand, not only that forthwith after the death of the insured claim was not made, but even within one calendar month, it has not been made. The death occurred on 27.08.2009, whereas from the copy of the claim petition, it can be seen, it was submitted on 06.01.2010. 12. Further, important point that needs to be noted is, the Complainant in the cross-examination has admitted that his father had also insured his life with New India Insurance Company and also he admits with that insurance company also they have made claim. He states, that claim also has not been settled. 13. P.W.1 in the cross-examination has admitted that Opposite party had informed him to produce documents to prove that his father died due to snake bite. As noted earlier, the Complainant has not furnished the relevant documents on the point. In the cross-examination, the Complainant has admitted that neither himself, nor the Doctor intimated to the police that his father died due to snake bite. 14. To prove the fact that the deceased died due to snake bite, the Complainant has examined a witness Dr.K.C.Chandrashekara. In the Chief examination itself, this Doctor has stated that attendants of the patient were advised to take post mortem. Admittedly, no post mortem was done. In the cross-examination, the Doctor has admitted that in case of accidental death, matter shall have to be reported to the police. In the case on hand, admittedly the death of the insured was not reported to the police. Though the Doctor has admitted that certain registers are maintained in the hospital, those registers are not produced. No reasons are assigned. For the Complainant, a document at Ex.C.3 is produced and in respect of that document, the Doctor has spoken. The Opposite party has challenged the said document contending that it is created. The doctor has admitted in the cross-examination that the said hospital at present is not in existence. Hence, when said hospital is not in existence, a question and a doubt would arise regarding the said document. On the front page of the said document, there is rubber stamp as M.L.C. When according to the hospital and doctor, it was medico legal case, in the routine course, the doctor and the hospital ought to have reported the matter to the police. Admittedly, that is not done. No reasons are assigned. Under the circumstances, we cannot brush aside the contention of the Opposite party that the said document has been created utilizing the old format. 15. Considering the facts and the material on record, the repudiation of the claim by the Opposite party on the ground that the Complainant did not produce copy of the FIR, Post Mortem Report or Panchanama, cannot be termed as illegal. Conducting post mortem is one of the mandatory conditions of the policy. Hence, we are of the opinion that the Complainant has failed to prove deficiency in service on the part of the Opposite party. According, we pass the following order: ORDER The complaint is dismissed. There is no order as to costs. (Dictated to the Stenographer, transcribed, corrected and then pronounced in the open Forum this the 24th day of August 2010). (PRESIDENT) (MEMBER) (MEMBER)
